Septic Long Bone Nonunion Repair Outcomes Are Associated With Culture Organisms

Area of Science:

• Orthopaedic Surgery
• Infectious Diseases
• Bone Healing

Background:

• Septic long bone nonunion presents a significant challenge in orthopaedic treatment.
• Understanding the impact of microbial profiles on treatment outcomes is crucial for optimizing patient care.

Purpose of the Study:

• To investigate the association between cultured organism species and treatment outcomes in patients with septic long bone nonunion.
• To determine if specific bacterial species influence the rate of unplanned procedures or the achievement of bone union.

Main Methods:

• Retrospective review of adult patients with septic long bone nonunion treated at a tertiary orthopaedic center from 2014 to 2023.
• Data collected included patient characteristics, surgical and antibiotic treatments, and cultured organisms.
• Outcomes assessed were unplanned operations and ultimate bone union, analyzed by cultured organism species.

Main Results:

• Of 101 patients, 86% achieved radiographic union.
• Polymicrobial infections were associated with a higher rate of unplanned procedures compared to monomicrobial infections (43% vs. 18%).
• Patients with negative cultures at the time of surgery had more unplanned procedures than those with positive cultures (60% vs. 30%).

Conclusions:

• While 86% of patients achieved union, specific bacterial species did not correlate with unplanned procedures or union rates.
• Polymicrobial infections necessitate more aggressive management strategies due to increased need for unplanned operations.
• Accurate culture data is vital for guiding effective antibiotic treatment regimens in septic nonunion cases.